ArticleClinical Medicine Insights. Oncology2026
Efficacy of Pembrolizumab as a Second- or Third-Line Therapy in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Multicenter Retrospective Study in Vietnamese Patients.
Article in Clinical Medicine Insights. Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: This present study aimed to evaluate the efficacy, safety, and prognostic factors of pembrolizumab in Vietnamese patients with platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). Methods: We performed a multicenter retrospective cohort study of 62 patients with platinum-refractory recurrent or metastatic HNSCC who received pembrolizumab monotherapy (200 mg every 3 weeks) from January 2020 to June 2024 at Vietnam National Cancer Hospital - K Hospital and Hanoi Oncology Hospital. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS), overall response rate (ORR) per RECIST v1.1, and safety per CTCAE v5.0. Survival was assessed using Kaplan-Meier methods, and prognostic factors were evaluated with multivariable Cox regression. Results: Among 62 patients (85.5% male, mean age 58.9±9.7 years), the ORR and disease control rate were 25.8% and 51.6%, respectively. Median PFS was 4.3 months (95% confidence interval [CI] 2.9-5.7), and median OS was 7.5 months (95% CI 5.9-9.1). Programmed death-ligand 1 (PD-L1) combined positive score (CPS) ≥20 was associated with improved PFS (hazard ratio [HR] 0.452, 95% CI, 0.245-0.832, P=0.005) and OS (HR 0.373, 95% CI 0.157-0.884, P=0.025). Pembrolizumab monotherapy was well-tolerated with grade 3-4 adverse events in 3.2% of patients and lack of treatment-related deaths. Conclusions: This real-world study confirms that pembrolizumab monotherapy provides clinically meaningful efficacy and favorable safety in later-line Vietnamese R/M HNSCC patients, with enhanced benefit in PD-L1 CPS≥20, supporting its role in resource-limited settings.
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